Journal of Vascular and Interventional Radiology最新文献

英文中文

Systematic Literature Review and Meta-analysis of the Cardiovascular Effects of Transjugular Intrahepatic Portosystemic Shunt Creation for Decompensated Liver Cirrhosis 经颈静脉肝内门静脉系统分流术治疗失代偿期肝硬化的心血管效应的系统文献综述和meta分析。

IF 2.6 3区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of Vascular and Interventional Radiology

Pub Date : 2025-11-24 DOI: 10.1016/j.jvir.2025.107924

Wali Badar MD , Ramzy C. Khabbaz MD, MS , Arinze Ekowa BS , Sarah Shalaby MD, PhD , Anna Baiges MD, PhD , Juan-Carlos García-Pagán MD, PhD , Ron C. Gaba MD, MS

Purpose

To characterize the cardiovascular (CV) effects of transjugular intrahepatic portosystemic shunt (TIPS) creation through systematic literature review and meta-analysis.

Materials and Methods

A systematic literature review was performed from 1990 to 2025. The search strategy included key words for TIPS creation, cardiac-related terms (eg, heart, CV, mitral, atrial, and ventricular), and clinical outcomes (eg, survival, mortality, and decompensation). Eligible articles were English language studies with >5 patients reporting CV outcomes after TIPS creation. Outcome measures included hemodynamic changes, CV index alterations, CV decompensation, and mortality. Data were aggregated, and pooled estimated effects were reported.

Results

Thirty-two articles with 4,452 patients were included. Right atrial pressure (RAP) (+5.2 mm Hg; 95% CI, 4.0–6.2; P < .001), cardiac output (CO) (+1.9 L/min; 95% CI, 1.3–2.7; P < .001), cardiac index (CI) (+1.0 L/min/m²; 95% CI, 0.6–1.4; P < .001), pulmonary artery pressure (PAP) (+8.6 mm Hg; 95% CI, 4.1–13.1; P = .006), pulmonary capillary wedge pressure (PCWP) (5.7 mm Hg; 95% CI, 2.1–9.3; P = .010), and E/A ratio (+0.2; 95% CI, 0.1–0.4; P = .016) significantly increased immediately after TIPS creation. RAP and E/A ratio returned to baseline 1–6 months after TIPS creation, whereas CO, CI, PAP, and PCWP did not. The pooled incidence of post-TIPS cardiac decompensation was 9% (95% CI, 4%–21%). One-year cardiac mortality rate was 3% (95% CI, 2%–5%). Diastolic dysfunction was associated with increased 1-year post-TIPS mortality (odds ratio, 2.26; 95% CI, 1.43–3.59; P = .001).

Conclusions

Transient CV changes and cardiac decompensation can occur after TIPS creation. Diastolic dysfunction may predict cardiac mortality.

目的：通过系统的文献回顾和荟萃分析，探讨经颈静脉肝内门静脉系统分流术（TIPS）的心血管（CV）效应。材料和方法：对1990-2025年的文献进行系统回顾。搜索策略包括经颈静脉肝内门静脉系统分流术、心脏相关术语（如心脏、心血管、二尖瓣、心房、心室）和临床结果（如生存、死亡率、失代偿）的关键词。符合条件的文章是5篇报告TIPS后CV结果的英语研究。结果测量包括血流动力学改变、心血管指数改变、心血管失代偿和死亡率。汇总数据并汇总估计效果。结果：纳入32篇文章，4452例患者。右房压（RAP）（+5.2 mmHg, 95% CI:4.0-6.2; P2, 95% CI:0.6-1.4; p）结论：TIPS后可发生一过性CV改变和心脏失代偿。舒张功能障碍可预测心脏死亡率。

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引用次数: 0

2025 Dotter Lecture: Innovating Innovation—Building on Dotter’s Legacy 2025波特讲座：创新创新：以波特的遗产为基础。

IF 2.6 3区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of Vascular and Interventional Radiology

Pub Date : 2025-11-24 DOI: 10.1016/j.jvir.2025.107923

Lindsay Machan MD, O.C.

引用次数: 0

Augmented Interventional Radiology via Augmented Reality 通过增强现实增强介入放射学

IF 2.6 3区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of Vascular and Interventional Radiology

Pub Date : 2025-11-21 DOI: 10.1016/j.jvir.2025.09.010

Laetitia Saccenti MD , Hannah Huth MD , Nicole Varble PhD , Ashley Gallagher MD , Michael Kassin MD , Ifechi Ukeh MD , Baris Turkbey MD , Keith Horton MD , Vania Tacher MD, PhD , Hicham Kobeiter MD, PhD , Bradley Pua MD , Charles Martin 3rd MD , Lindsey Hazen RN , William F. Pritchard MD, PhD , John W. Karanian PhD , Ming Li PhD , Bradford J. Wood MD

Augmented reality (AR) and virtual reality (VR) have the potential to transform interventional radiology (IR) by enhancing image guidance, procedural planning, and training. These technologies may enable more accurate and efficient interventions; both can improve outcomes. Applications include AR-guided procedures such as biopsies and ablations and VR-based training and tools to visualize radiation dose or improve patient comfort and education. To allow a successful transition into clinical workflow, technical challenges, such as real-time registration of imaging data on moving anatomy, autosegmentation, and device tracking, need to be addressed and potential paths for resolution need to be outlined. Immersive 3-dimensional visualization from AR may assist in needle navigation, margin confirmation, and standardization of ablation strategies. Hardware platforms, from headsets to smartphones and augmented displays, are described, each with specific trade-offs. Broader adoption depends on ergonomic, regulatory, and clinical validation and outcomes studies. AR/VR technologies hold promise for more precise, standardized, and accessible IR procedures in the future.

增强现实（AR）和虚拟现实（VR）有可能通过增强图像引导、程序规划和培训来改变介入放射学（IR）。这些技术可以实现更准确和有效的干预；两者都可以改善结果。应用包括ar引导程序，如活组织检查和消融，以及基于vr的培训和工具，以可视化辐射剂量或改善患者舒适度和教育。为了成功过渡到临床工作流程，需要解决技术挑战，例如运动解剖成像数据的实时注册，自动分割和设备跟踪，并且需要概述解决方案的潜在路径。AR的沉浸式三维可视化可能有助于针导航、边缘确认和消融策略的标准化。硬件平台，从耳机到智能手机和增强显示器，每一个都有特定的权衡。更广泛的采用取决于人体工程学、法规、临床验证和结果研究。AR/VR技术有望在未来实现更精确、标准化和可访问的红外程序。

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引用次数: 0

Facilitating Personalized Immunotherapy with Interventional Radiology and Tumor Organoids 利用介入放射学和肿瘤类器官促进个性化免疫治疗

IF 2.6 3区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of Vascular and Interventional Radiology

Pub Date : 2025-11-21 DOI: 10.1016/j.jvir.2025.08.038

Wei Tian MD, PhD , Anna Sophia McKenney MD, PhD, MPH , Chenyang Zhan MD, PhD

Personalized immunotherapy is a novel treatment approach aiming to increase precision and reduce toxicity compared with traditional immune checkpoint inhibitors. Tumor organoids derived from interventional radiology (IR) biopsy specimens can provide a powerful platform, positioning IR centrally in developing and delivering these therapies. Patient-derived tumor organoid (PDO) cultures amplify tumor biomass, enabling identification of tumor-specific neoantigens. Co-culture of PDOs with autologous immune cells allows activation and expansion of tumor-reactive T cells from the same patient, which can serve as biomarkers and therapeutic targets for investigating tumor-specific immune responses following locoregional therapies. IR can play a critical role in PDO-based personalized immunotherapy by providing tumor sampling for organoid culture and delivering locoregional therapies that not only control tumor progression but also prime systemic immune responses during therapy preparation. Although promising, organoid-based personalized immunotherapy remains mostly in preclinical stages. Integrating IR interventions with PDO platform could accelerate the clinical translation of personalized immunotherapy.

与传统的免疫检查点抑制剂相比，个性化免疫治疗是一种新的治疗方法，旨在提高精度和降低毒性。来自介入放射学（IR）活检标本的肿瘤类器官可以提供一个强大的平台，将IR定位在开发和提供这些治疗的中心。患者源性肿瘤类器官（PDO）培养物可扩增肿瘤生物量，从而鉴定肿瘤特异性新抗原。PDOs与自体免疫细胞的共培养允许来自同一患者的肿瘤反应性T细胞的激活和扩增，这可以作为局部区域治疗后研究肿瘤特异性免疫反应的生物标志物和治疗靶点。IR可以在基于pdo的个性化免疫治疗中发挥关键作用，为类器官培养提供肿瘤样本，并提供局部治疗，不仅可以控制肿瘤进展，还可以在治疗准备期间启动全身免疫反应。尽管前景看好，但基于类器官的个性化免疫疗法仍主要处于临床前阶段。将IR干预与PDO平台相结合，可加快个体化免疫治疗的临床转化。

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引用次数: 0

Nanoparticles as Multifunctional Drug-Delivery Systems: A Comprehensive Review and Integration into Interventional Oncology 纳米颗粒作为多功能药物传递系统：全面回顾并整合到介入肿瘤学中

IF 2.6 3区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of Vascular and Interventional Radiology

Pub Date : 2025-11-21 DOI: 10.1016/j.jvir.2025.08.037

Kentaro Yamada MD, PhD, Takeshi Suzuki MD, PhD, Khashayar Farsad MD, PhD

Nanoparticles hold considerable promise for enhancing image-guided treatment for localized cancer therapy. Traditional intra-arterial approaches such as transarterial chemoembolization often suffer from limited drug retention and induction of tumor hypoxia, triggering resistance and metastasis. Conversely, nanoparticles enable higher local drug concentrations and targeted delivery through passive and active mechanisms, potentially overcoming intratumoral heterogeneity. Moreover, these versatile platforms can incorporate imaging agents, allowing theranostic applications that integrate treatment and real-time monitoring. Nanoparticles can also be engineered for stimulus-responsive drug release, which reacts to features such as acidity or external triggers (eg, light and ultrasound [US]), to further improve spatiotemporal control. Beyond chemotherapy, immunomodulatory nanoparticles show promise in reshaping the tumor microenvironment and enhancing immunotherapy outcomes. Emerging research includes nanoparticle-mediated in vivo gene editing for hepatocellular carcinoma treatment, demonstrating the potential for synergy between advanced particle design and image-guided delivery. This review discusses these advancements, highlighting current challenges and envisioning future directions for clinical translation.

纳米颗粒在增强局部癌症的图像引导治疗方面具有相当大的前景。传统的动脉内入路，如经动脉化疗栓塞，往往存在药物潴留有限和诱导肿瘤缺氧的问题，从而引发耐药性和转移。相反，纳米颗粒可以通过被动和主动机制提高局部药物浓度和靶向递送，潜在地克服肿瘤内的异质性。此外，这些多功能平台可以结合显像剂，使治疗应用集成治疗和实时监测。纳米颗粒也可以被设计用于刺激反应性药物释放，它对酸度或外部触发因素（例如光和超声波[US]）等特征做出反应，从而进一步改善时空控制。除了化疗，免疫调节纳米颗粒在重塑肿瘤微环境和提高免疫治疗效果方面显示出希望。新兴研究包括用于肝细胞癌治疗的纳米颗粒介导的体内基因编辑，展示了先进颗粒设计和图像引导传递之间的协同作用潜力。这篇综述讨论了这些进展，强调了当前的挑战，并展望了临床翻译的未来方向。

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引用次数: 0

The Woodchuck Hepatitis Virus Model of Hepatocellular Carcinoma for Interventional Radiology Research 肝细胞癌土拨鼠肝炎病毒模型介入放射学研究

IF 2.6 3区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of Vascular and Interventional Radiology

Pub Date : 2025-11-21 DOI: 10.1016/j.jvir.2025.09.002

Sheridan L. Reed MD , Vishnu M. Chandra MD , William F. Pritchard MD, PhD , Andrew S. Mikhail PhD , John W. Karanian PhD , Carla S. Coffin MD, MSc , Bradford J. Wood MD , Luke R. Wilkins MD

Preclinical models that accurately recapitulate the pathogenesis, microenvironment, and therapeutic response of human hepatocellular carcinoma (HCC) are essential for advancing locoregional therapies. The woodchuck (Marmota monax) chronically infected with woodchuck hepatitis virus (WHV) offers a unique and highly translational large-animal model for HCC research. This manuscript reviews the utility of the WHV-woodchuck model, emphasizing its strengths in mimicking human HCC pathophysiology and its applicability to interventional radiology-based research. Unlike xenograft or chemically induced rodent models, WHV-infected woodchucks develop spontaneous HCC on a background of chronic viral hepatitis, is somewhat similar to the human disease in both tumorigenesis and tumor immune microenvironment. This makes the model particularly valuable for studying tumor-host interactions and assessing therapeutic responses in an immunocompetent setting. Importantly, the woodchuck size of 2-5kg permits the application of standard imaging and interventional techniques, including image-guided tumor ablation and transcatheter arterial embolization. The ability to perform serial imaging, targeted biopsies and localized therapies in this model provides a powerful platform for translational research in interventional oncology. While the model has logistical challenges, including seasonal breeding and specialized husbandry and care requirements, its unique advantages make it one of the most relevant preclinical systems for studying locoregional therapies in HCC.

准确概括人类肝细胞癌（HCC）的发病机制、微环境和治疗反应的临床前模型对于推进局部治疗至关重要。土拨鼠（旱獭）慢性感染土拨鼠肝炎病毒（WHV）为HCC研究提供了一种独特且高度可转化的大型动物模型。本文回顾了whv -土拨鼠模型的应用，强调了其在模拟人类HCC病理生理方面的优势及其在基于介入放射学的研究中的适用性。与异种移植或化学诱导的啮齿动物模型不同，whv感染的土拨鼠在慢性病毒性肝炎的背景下发生自发性HCC，在肿瘤发生和肿瘤免疫微环境方面与人类疾病有些相似。这使得该模型在研究肿瘤-宿主相互作用和评估免疫环境下的治疗反应方面特别有价值。重要的是，2-5kg大小的土拨鼠允许应用标准成像和介入技术，包括图像引导的肿瘤消融和经导管动脉栓塞。该模型能够进行连续成像、靶向活检和局部治疗，为介入肿瘤学的转化研究提供了强大的平台。尽管该模型在后勤方面存在挑战，包括季节性繁殖和专业化饲养和护理要求，但其独特的优势使其成为研究HCC局部治疗最相关的临床前系统之一。

{"title":"The Woodchuck Hepatitis Virus Model of Hepatocellular Carcinoma for Interventional Radiology Research","authors":"Sheridan L. Reed MD , Vishnu M. Chandra MD , William F. Pritchard MD, PhD , Andrew S. Mikhail PhD , John W. Karanian PhD , Carla S. Coffin MD, MSc , Bradford J. Wood MD , Luke R. Wilkins MD","doi":"10.1016/j.jvir.2025.09.002","DOIUrl":"10.1016/j.jvir.2025.09.002","url":null,"abstract":"<div><div>Preclinical models that accurately recapitulate the pathogenesis, microenvironment, and therapeutic response of human hepatocellular carcinoma (HCC) are essential for advancing locoregional therapies. The woodchuck (Marmota monax) chronically infected with woodchuck hepatitis virus (WHV) offers a unique and highly translational large-animal model for HCC research. This manuscript reviews the utility of the WHV-woodchuck model, emphasizing its strengths in mimicking human HCC pathophysiology and its applicability to interventional radiology-based research. Unlike xenograft or chemically induced rodent models, WHV-infected woodchucks develop spontaneous HCC on a background of chronic viral hepatitis, is somewhat similar to the human disease in both tumorigenesis and tumor immune microenvironment. This makes the model particularly valuable for studying tumor-host interactions and assessing therapeutic responses in an immunocompetent setting. Importantly, the woodchuck size of 2-5kg permits the application of standard imaging and interventional techniques, including image-guided tumor ablation and transcatheter arterial embolization. The ability to perform serial imaging, targeted biopsies and localized therapies in this model provides a powerful platform for translational research in interventional oncology. While the model has logistical challenges, including seasonal breeding and specialized husbandry and care requirements, its unique advantages make it one of the most relevant preclinical systems for studying locoregional therapies in HCC.</div></div>","PeriodicalId":49962,"journal":{"name":"Journal of Vascular and Interventional Radiology","volume":"36 12","pages":"Pages 1888-1893"},"PeriodicalIF":2.6,"publicationDate":"2025-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145555321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Remote Telerobotics in Interventional Radiology: Development, Procedures, and Challenges 介入放射学中的远程机器人：发展、程序和挑战

IF 2.6 3区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of Vascular and Interventional Radiology

Pub Date : 2025-11-21 DOI: 10.1016/j.jvir.2025.09.011

Wayne L. Monsky MD, PhD , Stephen P. Seslar MD, PhD , Ryan James PhD

People living in rural communities face significant health care disparities, having a tremendous impact on routine and emergent clinical care. A paucity of specialists, such as interventional radiologists, in rural and global isolated areas contributes to these disparities. The impact of telemedicine for remote clinical care has now been well established and is commonplace. A logical evolution of telemedicine is telesurgery and teleprocedural care. Robotic surgery is well established and now being applied in interventional radiology. These technologies have the capacity to democratize specialty care, literally extending the reach of interventionalists and surgeons to make procedural care available to these underserved communities. There is a clear need to develop future approaches that can address a large and growing rural health care disparity. Technical requirements and details of clinical workflow must first be understood and optimized.

生活在农村社区的人们面临着巨大的卫生保健差距，这对常规和紧急临床护理产生了巨大影响。农村和全球偏远地区缺乏介入放射科医生等专家，造成了这些差距。远程医疗对远程临床护理的影响现在已经得到了很好的确立，并且是司空见惯的。远程医疗的逻辑演进是远程外科手术和远程程序护理。机器人手术已经很成熟，现在正在介入放射学中得到应用。这些技术有能力使专业护理民主化，从字面上扩展了介入医生和外科医生的范围，为这些服务不足的社区提供程序性护理。显然需要制定未来的办法，以解决农村保健方面巨大且不断扩大的差距。首先要了解和优化临床工作流程的技术要求和细节。

引用次数: 0

Room Considerations for a Telerobotic Angiosuite 远程机器人血管套件的空间考虑

IF 2.6 3区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of Vascular and Interventional Radiology

Pub Date : 2025-11-21 DOI: 10.1016/j.jvir.2025.08.001

Nicholas J. Lima BS , John T. Moon MD , Hanzhou Li MD , Rebecca Le MD , Zachary Bercu MD

引用次数: 0

Subscription Information Page 订阅信息页面

IF 2.6 3区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of Vascular and Interventional Radiology

Pub Date : 2025-11-21 DOI: 10.1016/S1051-0443(25)00700-6

引用次数: 0

Artificial Intelligence and Intelligent Interventional Radiology: Fusion of Human and Machine 人工智能与智能介入放射学：人机融合

IF 2.6 3区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of Vascular and Interventional Radiology

Pub Date : 2025-11-21 DOI: 10.1016/j.jvir.2025.09.017

Hannah Huth MD , Laetitia Saccenti MD , James Anibal BS , Ifechi Ukeh MD , Michael Kassin MD , Judy Gichoya MD, MS , Nicole Varble PhD , Ming Li PhD , John Karanian PhD , Baris Turkbey MD , Bradford J. Wood MD

Although artificial intelligence (AI) is transforming the practice of medicine, its integration into the procedural space presents unique hurdles. Outlining a futuristic AI-driven interventional radiology (IR) workflow may help to narrow and redefine the wide range of theoretical applications. In this future workflow, diagnosis and preprocedural planning may be semiautomated and guided by an AI-driven multidisciplinary tumor board, outcome prediction analysis, noninvasive imaging biopsy, personalized therapeutics, and simulations. Ablations will include automatic segmentation, integrated registration, optimized device selection and trajectory prescription, robotic stereotaxy for large composite treatment volumes, AI response criteria, multimodality fusion, and iterative sphere packing to improve end-to-end procedural management. Additionally, AI virtual outcome prediction software will enable preplanning of robotic endovascular interventions with prescriptive maneuvers that minimize risk and time under anesthesia. Responsible integration of AI technologies will further the mission of IR to make medicine more personalized, minimally invasive, cost-effective, and safe.

尽管人工智能（AI）正在改变医学实践，但它与程序空间的整合存在独特的障碍。概述未来人工智能驱动的介入放射学（IR）工作流程可能有助于缩小和重新定义广泛的理论应用范围。在未来的工作流程中，诊断和术前计划可能是半自动的，并由人工智能驱动的多学科肿瘤委员会、结果预测分析、无创成像活检、个性化治疗和模拟指导。消融将包括自动分割、集成配准、优化设备选择和轨迹处方、大型复合治疗量的机器人立体定位、人工智能响应标准、多模态融合和迭代球体填充，以改善端到端程序管理。此外，人工智能虚拟结果预测软件将使机器人血管内干预的预先规划具有规范性操作，最大限度地减少麻醉下的风险和时间。负责任的人工智能技术整合将进一步推动IR的使命，使医疗更加个性化、微创、成本效益和安全。

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